What are the DSM-5 criteria for diagnosis of panic disorder?

Patients with panic disorder frequently present to the emergency department (ED) with chest pain or dyspnea, fearing that they are dying of myocardial infarction. They commonly report a sudden unexpected and spontaneous onset of fear or discomfort, typically reaching a peak within 10 minutes. DSM-5 criteria for panic disorder include the experiencing of recurrent panic attacks, with 1 or more attacks followed by at least 1 month of fear of another panic attack or significant maladaptive behavior related to the attacks. A panic attack is an abrupt period of intense fear or discomfort accompanied by 4 or more of the following 13 systemic symptoms:

Palpitations, pounding heart, or accelerated heart rate

Sweating

Trembling or shaking

Shortness of breath or feeling of smothering

Feelings of choking

Chest pain or discomfort

Nausea or abdominal distress

Feeling dizzy, unsteady, lightheaded, or faint

Chills or heat sensations

Paresthesias (ie, numbness or tingling sensations)

Derealization (ie, feeling of unreality) or depersonalization (ie, being detached from oneself)

[Guideline] American Psychiatric Association (APA). Practice guideline for the treatment of patients with panic disorder. 2nd ed. Washington (DC): American Psychiatric Association (APA); 2009 Jan. Available from the PsychiatryOnline website. Available at http://psychiatryonline.org/content.aspx?bookid=28&sectionid=1680635. Accessed: June 15, 2011.